© 2016 - Väth Consulting LLC REPORT CONTINUITY DOCUMENT Date Report Run: Date Report Complete: Report Time Frame: To Person Managing Report: People Doing Audit: Type of Report Used: Numerator: Denominator: Exclusions: Denominator Sample Size: Numerator Sample Size: Universe Size: Method of Sample Selection: Percentage Compliant: HEALTH CENTER GOAL: OUTCOME LAST YR: % Type of Report: Other Notes: Key For Audit Checklist For Reports Age still in inclusionary group? Gender correct in inclusionary group? Number approximately ballpark? Exceptions excluded? Visit requirements considered/met? Deceased patients excluded? Includes all sites? Duplicates? Test/sample patients removed? QUALITY IMPROVEMENT EFFORTS Policy Process Point of Care Alerts Documentation Retroactive Reporting Intervention History References

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REPORTCONTINUITYDOCUMENTDateReportRun: DateReportComplete: ReportTimeFrame: To PersonManagingReport: PeopleDoingAudit: TypeofReportUsed: Numerator: Denominator: Exclusions: DenominatorSampleSize: NumeratorSampleSize: UniverseSize: MethodofSampleSelection: PercentageCompliant: HEALTHCENTERGOAL: OUTCOMELASTYR: % TypeofReport: OtherNotes:

KeyForAudit ChecklistForReports

Agestillininclusionarygroup? Gendercorrectininclusionarygroup? Numberapproximatelyballpark? Exceptionsexcluded? Visitrequirementsconsidered/met? Deceasedpatientsexcluded? Includesallsites? Duplicates? Test/samplepatientsremoved?

QUALITYIMPROVEMENTEFFORTS

Policy Process PointofCareAlerts Documentation RetroactiveReporting InterventionHistory References

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